Beneficial effects of multidose coronary artery washout during elective cardiac arrest and cardiopulmonary bypass: biochemical and hemodynamic evaluation.

Coronary artery washout with buffered saline (pH 7.4) during 60 and 120 minutes of elective cardiac arrest was studied in dogs during moderate hypothermic cardiopulmonary bypass. Compared with results in a group undergoing simple ischemic arrest, significantly greater myocardial adenosine triphosphate concentrations were present at 90 and 120 minutes of cardiac arrest in the coronary artery washout group. After 60 minutes of aortic cross-clamping and 60 minutes of reperfusion, left ventricular function was significantly superior in the coronary artery washout group. Coronary artery washout during the period of aortic cross-clamping preserves dynamic myocardial performance during reperfusion and is an important principle of myocardial protection during elective cardiac arrest.